不同体位下肢被动踏踩训练对脑卒中下肢痉挛的影响  

Effect of passive stepping of lower limbs in two different positions on spasticity of lower extremities in stroke patients

作　　者：王盛[1] 王翔[1] 罗予[1] 卞荣[1] 顾绍华[1] 吴玉霞[1] 周秋敏[1] 王彤[1] 

机构地区：[1]江苏省人民医院康复医学科,南京2100292

出　　处：《中国康复》2012年第4期263-265,共3页Chinese Journal of Rehabilitation

摘　　要：目的:观察不同体位下肢被动踏踩训练对脑卒中患者患侧下肢痉挛的疗效。方法:脑卒中患者66例,随机分为直立组35例和坐位组31例,2组在接受常规康复训练的基础上分别进行直立位和坐位的下肢被动踏踩训练。分别在训练前、训练30min及4周后对患侧小腿三头肌、股四头肌、腘绳肌进行改良Ashworth痉挛评定。结果:治疗30min后,2组患者仅患侧小腿三头肌的Ashworth痉挛评分较治疗前明显降低(P<0.05),2组间比较差异无统计学意义;治疗4周后,2组患者除坐位组患侧股四头肌外其余各肌肉痉挛评分均较治疗前明显降低(P<0.05),直立组患侧小腿三头肌痉挛评分分值降低较坐位组更显著(P<0.05)。结论:直立和坐位下肢被动踩踏训练均能降低脑卒中患者偏瘫侧下肢的痉挛,其中直立下肢被动踏踩训练对缓解患侧小腿三头肌的痉挛效果更好。Objective： To study the effect of passive stepping of lower limbs in two different positions on spasticity of lower hemiplegia extremities in stroke patients. Methods： Sixty-six stroke patients were randomly divided into the vertical （n= 35） and sitting （n= 31） passively stepping training groups. Both groups received conventional reha- bilitation, and the passively stepping in the sitting or upright positions. The muscle （triceps surae, quadriceps and hamstrings ） of each group was assessed with the Modified Ashworth Scale before, 30 rain and 4 weeks after train- ing. Results： Thirty min after training, the Modified Ashworth scores of the triceps surae in both groups were de- creased significantly （P〈0.05）. There was no significant difference between two groups. Four weeks after train- ing, the scores of all muscles in two groups except quadriceps in sitting group were decreased obviously （P〈0.05）. The scores of triceps surae in vertical group were decreased more significantly than those of sitting group （P〈0.05）. Conclusion： Both positioned training could relieve the muscle spasticity of hemiplegic lower limbs in stroke patients, and passive stepping training in upright position had better effect in alleviating the spasticity of triceps su- rae muscle.

关 键 词：踏踩训练 体位 脑卒中 痉挛 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]